Çarkıt Sedat, İpekten Funda, Karaağaç Mustafa, Gök Mustafa, Akyuz Muhammet
Department of General Surgery, Erciyes University Faculty of Medicine, Kayseri-Türkiye.
Department of Biostatistics, Adıyaman University Faculty of Medicine, Adiyaman-Türkiye.
Ulus Travma Acil Cerrahi Derg. 2024 Jan;30(12):875-882. doi: 10.14744/tjtes.2024.26020.
Esophageal perforation is a serious medical condition where a hole or tear develops in the esophagus, the muscular tube that connects the throat to the stomach. Although rare, the condition is potentially life-threatening, as it can lead to infection and inflammation in surrounding tissues, including the mediastinum, pleura, and peritoneum.
Between 2014 and 2022, a retrospective study was conducted on cases of esophageal rupture treated at our institution. Eighteen cases were included in the study. Patient data, including age, gender, risk factors, delay in diagnosis, diagnostic method, site of perforation, etiology of perforation, treatment approach, complications, length of hospital stay, and outcomes, were collected. The Pittsburgh Severity Score (PSS) was calculated for each patient.
The mean patient age was 46.33 years, with a male predominance (72.2%). Causes included iatrogenic (22.2%), foreign body (50%), and trauma (27.8%). Perforations primarily occurred in the cervical (38.9%), thoracic (33.3%), and distal esophagus (27.8%). Higher mortality was associated with elevated white blood cell count (WBC), delayed diagnosis, and contrast leakage (p<0.05). Computed tomography (CT) findings and complications significantly influenced intensive care unit (ICU) stay, with abscesses reducing and mediastinitis increasing the duration (p<0.05). Other factors, including age, length of hospitalization, gender, etiology, and treatment type, did not significantly affect Pittsburg Severity Scores (p>0.05).
Esophageal perforation remains a challenging clinical condition associated with significant morbidity and mortality. To optimize patient outcomes, rapid diagnosis, risk stratification using tools such as the PSS, and tailored management strategies are essential.
食管穿孔是一种严重的病症，即连接咽喉与胃部的肌性管道食管出现孔洞或撕裂。尽管这种情况罕见，但它可能危及生命，因为它会导致周围组织（包括纵隔、胸膜和腹膜）发生感染和炎症。
2014年至2022年期间，对我院治疗的食管破裂病例进行了一项回顾性研究。该研究纳入了18例病例。收集了患者数据，包括年龄、性别、危险因素、诊断延迟、诊断方法、穿孔部位、穿孔病因、治疗方法、并发症、住院时间和结局。为每位患者计算匹兹堡严重程度评分（PSS）。
患者平均年龄为46.33岁，男性占主导（72.2%）。病因包括医源性（22.2%）、异物（50%）和外伤（27.8%）。穿孔主要发生在颈部（38.9%）、胸部（33.3%）和食管远端（27.8%）。白细胞计数升高、诊断延迟和造影剂外漏与较高的死亡率相关（p<0.05）。计算机断层扫描（CT）结果和并发症对重症监护病房（ICU）住院时间有显著影响，脓肿会缩短住院时间，纵隔炎会延长住院时间（p<0.05）。其他因素，包括年龄、住院时间、性别、病因和治疗类型，对匹兹堡严重程度评分没有显著影响（p>0.05）。
食管穿孔仍然是一种具有挑战性的临床病症，伴有显著的发病率和死亡率。为了优化患者结局，快速诊断、使用PSS等工具进行风险分层以及制定个性化的管理策略至关重要。
